Reliability and Validity Study of the Turkish Version of the Clinical Opiate Clinical Scale

Amaç: Bu çalışmada opiyat yoksunluk şiddetini belirlemek için kullanılan Klinik Opiyat Yoksunluk Ölçeği (KOYÖ) Türkçe sürümünün güvenilirliği ve geçerliliğinin incelenmesi amaçlanmıştır. Yöntem: KOYÖ, önce Türkçe'ye ardından yeniden İngilizce'ye geri çevrildi. İngilizce'ye çevirisi yapılan sürümün özgünlüğü, ölçeği geliştiren çalışmacı-lar tarafından onaylandı. Çeviri işleminin tamamlanmasının ardından ölçek opiyat yoksunluğunda olan 100 hasta ile alkol yoksunluğunda olan 41 has-tanın yoksunluk bulgularını değerlendirmek üzere kullanıldı. Güvenilirlik değerlendirmesinde Cronbach alfa; yapısal geçerlilik değerlendirmesinde açıklayıcı ve doğrulayıcı faktör analizi; ölçüt geçerliliğinde ise tanı grupları arasında ROC analizi kullanıldı. Bulgular: Güvenilirlik çözümlemelerinde Cronbach alfa iç tutarlılık katsa-yısı 0,74 olarak hesaplanmıştır. Görüşmeciler arası bağıntı katsayısı 0,975 (p<0,001) olarak elde edilmiştir. Ölçeğin yapı geçerliliği için açıklayıcı faktör çözümlemesi yapılmış ve ölçeğin tek boyutlu yapısını destekleyen bulgular saptanmıştır. Doğrulayıcı faktör analizinde CFI, GFI ve RMSEA değerlerinin sırasıyla 0,905, 0,905 ve 0,079 olduğu bulunmuştur. KOYÖ'nün opiyat ve alkol yoksunluk bulgularını ayırt etmede başarılı olduğu ve ROC eğrisinin altında kalan alanın 0,878 olduğu saptanmıştır.Sonuç: Bu çalışma ile Klinik Opiyat Yoksunluk Ölçeği (KOYÖ) Türkçe sürü-münün opiyat yoksunluğunu değerlendirmede güvenilir ve geçerli biçimde kullanılabileceği gösterilmiştir.Introduction: The aim of the present study was to perform reliability and validity analyses of the Turkish version of the Clinical Opiate Withdrawal Scale which is used to determine the severity of opiate withdrawal.Methods: Initially, the Clinical Opiate Withdrawal Scale (COWS) was translated into Turkish and subsequently back-translated into English. The originality of the back-translated version was approved by the author who developed the scale. After the translation was completed, the scale was used to assess the withdrawal symptoms of 100 patients with opiate withdrawal and 41 patients with alcohol withdrawal. Cronbach's alpha was used in the reliability assessment; explanatory and confirmatory factor analyses were used in structural validity assessment; and in scale validity, ROC analysis was used among diagnosis groups Results: The Cronbach's alpha internal consistency coefficient was calculated as 0.74 in reliability analyses. The correlation coefficient was found to be 0.975 (p&lt;0.001) for inter-rater reliability. Factor analysis was conducted for the structural validity of the scale and findings that support the unidimensional structure of the scale were observed. In the confirmatory factor analysis, CFI, GFI and RMSEA values were found to be 0.905, 0.905 and 0.079, respectively. It was detected that COWS was successful in distinguishing between opiate and alcohol withdrawal symptoms and the area under the ROC curve was 0.878.Conclusion: This study showed that the Turkish version of COWS can be used reliably and validly for assessing opiate withdrawa

Co-occurrence of substance use disorders with anxiety disorders: Epidemiology, psychobiology, clinical features, and treatment

Symptoms of anxiety and anxiety disorders commonly co-occur with substance use disorders (SUDs). The interaction between these disorders is bidirectional: anxiety disorders may contribute to the development of SUDs and modify the presentation and the outcomes of treatment for SUDs; on the other hand, SUDs may modify the manifestation of anxiety disorders. Anxiety symptoms are also accompanied with intoxication or withdrawal symptoms. Studies in clinical samples and community surveys have demonstrated high rates of co-occurrence of anxiety disorders with alcohol and drug use disorders. In National Epidemiologic Survey on Alcohol and Related Conditions, 17.71% of respondents with any 12 month substance use disorder had at least one independent anxiety disorder and 14.96% of respondents with any 12-month anxiety disorder had at least one substance use disorder, during the same 12-month period. Despite the high prevalence rates, anxiety disorders are frequently under-diagnosed in substance abuse settings. However, it is clinically important while the outcome for each type of disorder is worse across clinical and psychosocial domains than for the disorders without comorbidity. Integrated treatment strategies including medications and psychosocial treatment perspectives are needed for co-occurring anxiety and substance disorders to improve outcome. © 2010 Nova Science Publishers, Inc. All rights reserved

Possible Causal Link Between Idiopathic Intracranial Hypertension and the Misuse of Codeine-Based Products

WOS: 000386136000016PubMed ID: 2621897

Seroprevalence of hepatitits B, hepatitits C, HIV, and syphilis infections among non-injecting drug users

WOS: 000345917100010Background: While injection drug use is clearly a significant risk factor for the acquisition of certain infectious diseases, non-injection drug users (NIDUs) may also have higher risk than the general population, due to their involvement in risky behaviors. This study aimed to examine the prevalence of anti-HIV, anti-HCV, and HBsAg and VDRL seropositivity among a sample of non-injecting drug users. Methods: Medical records of the drug users who attended to our psychiatry clinics between April 2010 and April 2011 were reviewed and 55 non-injecting drug users without a previous history of intravenous drug use were identified. Anti-HIV, anti-HCV, HBs-Ag and VDRL assay results have been extracted and seroprevalence rates were calculated. Results: All but one NIDUs were male (n=54; 98.2%); 28 (50.9%) were between 15 and 25 years of age. Serologically, only one patient (a heroin user) was tested positive for HBsAg (1.8%) and one patient (a heroin user) was anti-HCV positive. None of the patients screened for anti-HIV or VDRL were tested positive. Conclusions: This study found low seropositivity rates for HBV, HBC, HIV and VDRL among a group of NIDUs, which might be related to the cultural characteristics of the region

Prevalence of Risky Behaviors and Relationship of Risky Behaviors with Substance Use Among University Students

Amaç: Genç yetişkinlik döneminde sıklıkla karşılaşılan riskli davranışların üniversite popülasyonundaki yaygınlığı ve madde kullanımı ile ilişkisinin değerlendirilmesi amaçlanmıştır.Yöntem: Kesitsel, web-tabanlı, öz bildirime dayalı çalışma, 53,003 öğrencisi olan bir devlet üniversitesinde gerçekleştirilmiştir. Örneklem sayısı için, Türkiye'deki üniversitelerde madde kullanımının en düşük prevelansına (%0.01-%0.6) göre güç analizi kullanılmıştır. Araştırma için 3,184 kişilik örneklem sayısı yeterli bulunmuştur. Bağımlılık Profil İndeksi Anketini tamamlayan 2,973 kişinin verileri değerlendirilmiştir. İstatistiksel analizlerde frekans testleri, Pearson ki-kare ve lojistik regresyon kullanılmıştır.Bulgular: Araştırmaya 1,629 (%54.8) kadın ve 1,344 (%45.2) erkek katıldı. Kadınlarda intihar planı ya da girişimi ve kendine zarar verme davranışı (KZVD); erkeklerde çakı, bıçak, tabanca gibi silahları taşıma, kavga etme ve yaralanma, erken yaşta cinsel ilişki deneyimi, kondom kullanımı, sigara, alkol, enerji içeceği ve madde kullanımı anlamlı düzeyde yüksek bulundu (p<0.001). Sık intihar planı ve girişimi (11.3 kat), 15 yaşından önce cinsel ilişki deneyimi (16.6 kat) madde kullanımında daha riskli davranışlar olarak bulundu. Sigara, alkol ve enerji içeceği kullanım sıklığı arttıkça madde kullanımı riskinin de arttığı saptandı. Sonuç: Gençlerde, risk alma davranışlarında cinsiyet faktörü ayırıcı özelliklerden biridir. Riskli davranışlar ve madde kullanımı arasındaki ilişki, bir riskli davranışın başka bir riskli davranışa yol açabileceğini düşündürür. Bu nedenle, riskli davranışlarda bulunan genç yetişkinlerde madde kullanımının, madde kullanım sorunu ile gelen genç yetişkinlerde de diğer riskli davranışların değerlendirilmesi gerekirPrevalence of risky behaviors and relationship of risky behaviors with substance use among university studentsObjective: This study aims to evaluate the prevalence of risky behaviors, frequently encountered in young adulthood, and the relationship between such behaviors and substance use in the university population.Method: This cross sectional, web-based, self-report study was carried out in a state university with 53,003 students. The power analysis was conducted according to the lowest prevalence (0.01%-0.6%) of substance use in universities in Turkey. A sample of 3,184 people was found to be sufficient for the research. The data of 2,973 individuals who completed the Addiction Profile Index was evaluated. Frequency tests, Pearson chi-square and logistic regression were used in the statistical analysis.Results: As participants 1,629 (54.8%) females and 1,344 (45.2%) males were included in the study. Suicidal plans or attempts and self-harming behaviors were significantly more prevalent among female students; carrying a weapon (penknife/knife/gun), engaging in physical fights, sustaining injuries in physical fights, early sexual relation experiences, condom usage, cigarette, alcohol, energy drink and substance consumption were significantly more prevalent among male students (p<0.001). Frequent suicidal plans or attempts (11.3 times) and early sexual experiences, before the age of 15 (16.6 times) were found to be riskier behaviors with regard to substance use; as the consumption of cigarettes, alcohol and energy drink increased, so did the risk of substance use.Conclusion: Gender is a distinctive characteristic with regard to risky behaviors among young people. The relationship between risky behaviors and substance use suggests that one risky behavior may lead to another. As such, it is necessary to evaluate the substance use among young people with risky behaviors and to examine other risky behaviors which accompany the substance use problem

A Multidisciplinary Approach to Addiction Developed in a Patient Receiving Chronic Pain Treatment with Fentanyl

WOS: 000328090600012Fentanyl, an opioid analgesic, started to be used more widely in patients with chronic pain who do not respond to a standard pain treatment. Reports of cases involving abuse and addiction are increasing rapidly when it is used for a reason other than medical treatment. This article presents a case where fentanyl was started for chronic pain treatment but addiction developed after a short time and discusses how the use of opioid analgesics can be regulated in patients with chronic pain in the light of the literature. The aim was to attract attention to the importance of standardizing and controlling treatments with this group of medication in our country where family medicine is becoming widespread

The relationship between migration and substance use on individuals who are routed to the substance abuse treatment due to probation act

WOS: 000388116800008Objective: Izmir, is one of the major metropolises of Turkey has migration in an increasing scale. Migration is an important fact that determining economic, social, cultural conditions and forming social environment of individuals. This study is about the relationship between migration which determines socioeconomic structure and substance use patterns on individuals who applied for the treatment of substance abuse by probation law to the Ege University, Faculty of Medicine and Addiction Clinic. Methods: The study was conducted with 302 people who agree to participate as a volunteer between the date of 01.10.2014-31.03.2015. The questionnaire, developed by the researchers, was used as a data collection tool. The collected data was evaluated in SPSS 15.0 Program and analyzed by chi-square, Fisher's exact test and t test. Findings: According to obtained findings, it has been seen that, comparing with natives, immigrants have higher rates on criteria of lower maternal education level, having more than two children, living as a tenant, high sibling number and interfering other crimes. Established relationships were found to be statistically significant. While, among the natives, the most important reason in starting substance use was detected as 'curiosity', it has been remarkably seen that among the migrating participants, personal matters as a reason of beginning substance use has a higher rate. This finding shows the differentiation among two groups. Result: Immigrants, settle out of the city and continue their lives in worse conditions than the ones who live in the city center. Therefore, they cannot benefit adequately positive opportunities of city because of environment, family and individual factors. This disadvantaged conditions encompasses immigrants increasingly. The higher rate of involving in other crimes among the participants who immigrated to Izmir shows how this situation relates with crime. For this study, it is expected to contribute the detections of risk for substance use, in order to prevent drug use in determining of public policy, development of regulations needs to be done and take the necessary protective measures